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Positioning for Value-Based Reimbursement: Leveraging Care Management for Clinical and Financial Outcomes
Positioning for Value-Based Reimbursement: Leveraging Care Management for Clinical and Financial Outcomes
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While others wait for the healthcare industry to complete its transition to value-based reimbursement, Bon Secours Medical Group has already aligned itself with payment reform, leveraging its care team and providers and automating workflows to enjoy immediate rewards from its patient-centered approach.

Positioning for Value-Based Reimbursement: Leveraging Care Management for Clinical and Financial Outcomes describes how this 600-provider medical group has primed its providers to employ a broad mix of team-based care, technology and retooled care delivery systems to maximize quality and clinical outcomes and reduce spend associated with its managed patients.

In this 25-page resource, Jennifer Seiden, administrative director, population health, Bon Secours Medical Group, and Lu Bowman, population health market program manager, Bon Secours Medical Group, share how a reframed approach to care transition management and chronic care management pays off in improved population health and decreased spend.

In Positioning for Value-Based Reimbursement: Leveraging Care Management for Clinical and Financial Outcomes, Ms. Seiden and Ms. Bowman review the following:

  • Medical home principles at the heart of BSMG's accountable care approach;
  • Reshaping the care team to include EMTs, pharmDs, community workers, and others;
  • Adopting a population health mindset that encompasses the full practice panel instead of just patients seen daily;
  • Technologies to identify and manage patients 'below the waterline';
  • Use of nurse navigators to manage care for high-complexity patients;
  • The return on investment equation that builds a business case for team-based care and protects this valuable investment;
  • Practical considerations for billing via Medicare's new Chronic Care Management codes—eligibility, reporting, exclusions, and others;
  • Care coordination responsibilities in BSMG's advanced patient-centered medical home model;
and much more, including program results and ROI and the role BSMG envisions for skilled nursing facilities in coordinating patient transitions across the care continuum.

Table of Contents

  • Bon Secours Medical Group Workforce Development for Transitional Care, Chronic Care Management
    • Evolution to Value-Based Contracting
    • Medical Home Principles Form Care Foundation
    • Profiting from Healthcare's Transition to Value-Based Care
    • Stratifying Below the Water Line
    • Moderate- Versus High-Complexity Patients
    • Return on Investment Equation
    • Care Management Services
    • Billing with Medicare Chronic Care Management Code
    • Chronic Care Management Reporting
    • Care Team in Advanced Patient-Centered Medical Home
    • Results and ROI
  • Q&A: Ask the Experts
    • Using EMTs in Team-Based Care
    • Educating Patients on Chronic Care Management Codes
    • Telehealth CPT Codes for Commercial Payors
    • Documenting Care Coordination
    • Role of SNFs in Bon Secours Continuum
    • Use and Benefits of Patient Registries
    • Remote Monitoring in Chronic Care
    • Using Respiratory and Physical Therapists
  • Glossary
  • For More Information
  • About the Contributors
Publication Date: March 2015
Number of Pages: 25
ISBN 10: 1-941329-66-7 (Print version); 1-941329-67-5 (PDF version)
ISBN 13: 978-1-941329-66-5 (Print version); 978-1-941329-67-2 (PDF version)
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